Chronic Lymphocytic Leukemia (CLL): Spleen Surgery 

When you have chronic lymphocytic leukemia (CLL), surgery is sometimes done to remove a swollen spleen. But this is rare. This procedure is called a splenectomy. The goal is not to cure CLL but to improve symptoms. This surgery is not used as often now for treating CLL. This is because other treatments work well to control CLL and keep the spleen from swelling.

What is the spleen?

The spleen is an organ near the stomach in the upper left side of the belly. It helps fight infection and filters old, damaged blood cells out of the blood. If your spleen is removed, your lymph nodes and liver can take over some of the spleen's functions. But you will be at higher risk for infection.

When splenectomy is done for CLL

A splenectomy may help improve blood counts and ease pressure and discomfort caused by an enlarged spleen. Your healthcare provider may suggest that you have a splenectomy if you have one or both of these problems:

• Your spleen is so swollen that it's pushing on other organs, like your stomach. Other treatments, such as chemotherapy or radiation therapy, are used first to try to shrink the spleen.

• Your spleen is filtering out too many red blood cells and platelets from your blood. It's your spleen's job to remove worn-out blood cells. But leukemia can make your spleen overactive. A splenectomy can help raise your red blood cell and platelet counts.

Vaccines before your surgery

You may need some vaccines before surgery. This is because your risk for certain infections will increase after your spleen is removed.

What to expect for your surgery

A surgeon does a splenectomy in a hospital. The surgery will take from 90 minutes to 3 hours. It depends on the way the surgery is done. It can be done by making one large cut (incision) or several smaller incisions in your abdomen (belly). The main artery going to your spleen is tied off. The spleen is taken out. Your incision is then closed with stitches (sutures). Talk to your healthcare provider about whether you'll need to stay in the hospital after surgery.

Preventing infections after a splenectomy

You'll need to be careful to avoid infection after your surgery and for the rest of your life. That's because your spleen can no longer help protect you against some types of infection. Your healthcare provider will likely encourage you to get vaccines to help prevent certain bacterial infections. Talk with your provider about this surgery and what you can expect after it.